OBJECTIVE: The objective of this study was to examine the association between online review content of SUD treatment facilities and drug-induced state mortality.
METHODS: A cross-sectional analysis of online reviews and ratings of Substance Abuse and Mental Health Services Administration (SAMHSA)-designated SUD treatment facilities listed between September 2005 and October 2021 was conducted. The primary outcomes were (1) mean online rating of SUD treatment facilities from 1 star (worst) to 5 stars (best) and (2) average drug-induced mortality rates from the Centers for Disease Control and Prevention (CDC) WONDER Database (2006-2019). Clusters of words with differential frequencies within reviews were identified. A 3-level linear model was used to estimate the association between online review ratings and drug-induced mortality.
RESULTS: A total of 589 SAMHSA-designated facilities (n=9597 reviews) were included in this study. Drug-induced mortality was compared with the average. Approximately half (24/47, 51%) of states had below average (\"low\") mortality rates (mean 13.40, SD 2.45 deaths per 100,000 people), and half (23/47, 49%) had above average (\"high\") drug-induced mortality rates (mean 21.92, SD 3.69 deaths per 100,000 people). The top 5 themes associated with low drug-induced mortality included detoxification and addiction rehabilitation services (r=0.26), gratitude for recovery (r=-0.25), thankful for treatment (r=-0.32), caring staff and amazing experience (r=-0.23), and individualized recovery programs (r=-0.20). The top 5 themes associated with high mortality were care from doctors or providers (r=0.24), rude and insensitive care (r=0.23), medication and prescriptions (r=0.22), front desk and reception experience (r=0.22), and dissatisfaction with communication (r=0.21). In the multilevel linear model, a state with a 10 deaths per 100,000 people increase in mortality was associated with a 0.30 lower average Yelp rating (P=.005).
CONCLUSIONS: Lower online ratings of SUD treatment facilities were associated with higher drug-induced mortality at the state level. Elements of patient experience may be associated with state-level mortality. Identified themes from online, organically derived patient content can inform efforts to improve high-quality and patient-centered SUD care.
目的:本研究的目的是检查SUD治疗设施的在线综述内容与药物诱导的状态死亡率之间的关系。
方法:对2005年9月至2021年10月期间列出的药物滥用和精神卫生服务管理局(SAMHSA)指定的SUD治疗设施的在线评论和评级进行了横断面分析。主要结果是(1)SUD治疗设施的平均在线评级从1星(最差)到5星(最佳),以及(2)疾病控制和预防中心(CDC)WONDER数据库(2006-2019)的平均药物诱导死亡率。确定了评论中频率不同的单词簇。使用3级线性模型来估计在线评论评级与药物引起的死亡率之间的关联。
结果:本研究共纳入589家SAMHSA指定的设施(n=9597条综述)。将药物诱导的死亡率与平均值进行比较。大约一半(24/47,51%)的州死亡率低于平均水平(“低”)(平均每100,000人死亡13.40,SD2.45),一半(23/47,49%)的药物诱导死亡率高于平均水平(“高”)(平均21.92,SD3.69每100,000人死亡)。与低药物死亡率相关的前5个主题包括戒毒和成瘾康复服务(r=0.26),对康复的感激(r=-0.25),感谢治疗(r=-0.32),关怀的员工和惊人的经验(r=-0.23),和个性化恢复计划(r=-0.20)。与高死亡率相关的前5个主题是医生或提供者的护理(r=0.24),粗鲁和不敏感的护理(r=0.23),药物和处方(r=0.22),前台和接待经验(r=0.22),和对沟通的不满(r=0.21)。在多级线性模型中,每100,000人中有10人死亡的州死亡率增加与平均Yelp评分低0.30相关(P=.005)。
结论:在州一级,SUD治疗设施的较低在线评级与较高的药物诱导死亡率相关。患者体验要素可能与州级死亡率相关。从网上确定的主题,有机地得出的患者内容可以为改善高质量和以患者为中心的SUD护理提供信息。